Time to End Food Allergy Tragedies

IF THE stock epinephrine bill passes, it will be a big step forward. But school staff also must be trained. “We need people who are knowledgeable on when and how to use the auto-injector,” says Maria Acebal, board member of the allergy organization FARE, which is leading the lobby for the bill.

Teachers, like others, may struggle with the fear of needles and drugs – even though medical experts say the auto-injected epinephrine is safe. “Unless the school gives them the information they need,” says Acebal, “it’s a very scary situation for them.” Sicherer thinks it shouldn’t be hard to show the teachers how to recognize a severe allergic reaction and treat it with a simple injection: “If a parent can learn it, any adult can learn it, and adults in charge of our children should learn it.”

Yet one study in 2000 of 101 families with kids with food allergies showed that only about half of them owned non-expired auto-injectors. It also revealed that only 32 per cent of the parents knew how to handle the device properly.

“You are modeling behavior for your children,” says Acebal. If a parent is scared of the auto-injector, what does that say to the child? Parents need to work with their child’s doctor on a plan to avoid the allergen, recognize symptoms, and treat the reaction. This plan then must be shared with the school.

Why Stop at Schools?

The campaign to make epinephrine more widely available and stop the tragedies has naturally begun with the schools. But why stop there? We can prevent even more needless deaths and traumatic hospital visits if we start viewing the epinephrine auto-injector like any other rescue device. The automated external defibrillator delivers a jolt that can save a person from cardiac arrest. AEDs are all over the place – in government and corporate offices, shopping centers, airports, sports stadiums and movie theaters.

Why not put auto-injected epinephrine devices right beside them? It makes sense to anyone who worries that a person might collapse at a movie theater or in a restaurant only because they forgot their auto-injector and one wasn’t available. Yet if you suggest that possibility to employers or restaurant managers, you’ll probably hear the following objection: It’s against the law to give someone else an injection of a prescription drug unless you are specifically authorized to do so.

Is that true? Do state laws actually prevent you from giving a shot of epinephrine to save a life? Chris Weiss doesn’t agree. “I’ve never seen a law that backs that up,” says the former vice-president of government relations for FAAN (now known as FARE). “Epinephrine is a benign medication. Why would someone be sued for giving epinephrine? That’s like being held liable for giving someone oxygen.” In fact, there are Good Samaritan state laws that would protect the rescuer.

Weiss notes that some states already allow lifeguards, tour guides, park rangers and camp counselors to store auto-injectors and give the shot of life to anyone suffering an anaphylactic reaction. However, this is only true in some states. “It’s a crapshoot,” says Weiss.

So will we see auto-injectors on the wall alongside the AEDs? Some practical issues need to be resolved first: Where would they be kept? How will an organization make sure they’re replaced every year to be certain the medicine hasn’t expired? Who will be authorized to use them, and how will those individuals be trained? It will take a while, but “I think it will happen,” says Weiss.

In the meantime, Bill 1107 in the Virginia legislature just awaits the governor’s signature to become law. [*See UPDATE below.] This bill would oblige all the state’s schools to stock two auto-injectors, and it would allow trained school employees to give epinephrine without fear of being sued. Perhaps it’s coincidence but the number of the bill matches Amarria’s birthday, November 7, the day she opened the gift of an MP3 player and sang all day.

“She was robbed of her life,” says Laura, who cries every morning and wonders when she’ll be able to pull herself together enough to go back to work. Laura doesn’t sleep much these days, but she does see one ray of hope. Maybe the new legislation could be called Amarria’s Law. “The least they can do is name it after her,” she says, choking back tears. “It would give me a little comfort to know that her death was not in vain.”

*UPDATE: On April 27, 2012, Virginia Governor Robert F. McDonnell signed legislation, dubbed Amarria’s Law, to establish policies requiring schools to have epinephrine on hand for a school nurse or trained staff to administer in case of an allergy emergency. Laura Pendleton (Amarria’s mother) was on hand to witness and support the passing of the legislation.

UPDATE 2: More states have now passed stock epinephrine laws: read more here. And on November 13, 2013, the President signed into law a federal act that provides incentives to states that enact state stock epinephrine laws. Read more here.

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